As one of the first pilot eight-year clinical medicine education institutions, Xiangya School of Medicine has already put it into practice for almost 12 years. After years exploring and reforming, its cultivating plan has already been built up. This paper will make a brief comparative analysis between 2004 version and 2012 version in cultivating objectives, model and characteristics, demonstrated the development and reform of its eight-year program education, shown its features such as strengthening the basic knowledge, emphasizing the clinical skills, cultivating the capabilities, and broadening the international perspectives, and attempt to contact the residency and research training, in order to provide the reference for the eight-year program education reform.

Objective To evaluate 99Tcm-MIBI imaging in patients with hyperparathyroidism and its correlation with serum intact PTH level. Methods Seventy patients with suspicious hyperparathyroidism underwent 99Tcm-MIBI imaging and serum intact PTH measurement. Abnormal increased uptake lesion appeared at early phase and even more clearly at delayed phase was considered as the positive by 99Tcm-MIBI imaging. A cut-off value of PTH ＞ 88 ng/L was taken as the criteria for hyperparathyroidism diagnosis. The diagnostic efficacy of 99Tcm-MIBI imaging combined with serum PTH measurement was assessed according to post-surgical histopathology or clinical follow-up. For those operated patients, Pearson correlation coefficient between serum PTH and the gland volume was calculated. Results Hyperparathyroidism was confirmed in 38 patients by histopathology (n = 36) or follow-up (n = 2). The overall diagnostic accuracy of 99Tcm-MIBI imaging was 90.0% (63/70), in which the accuracy was 80.0% (12/15) for patients with normal serum PTH and 92.7% (51/55) for those with elevated serum PTH. False positive 99Tcm-MIBI imaging were found in 3 patients with normal serum PTH. The diagnostic accuracy of abnormally high serum PTH combined with 99Tcm-MIBI imaging was 94.3% (66/70). There was a positive correlation between serum PTH level and the volume of pathologic parathyroid glands (r = 0.782, P ＜ 0.001 ). Conclusions Serum PTH measurement may help to improve the diagnostic accuracy of 99Tcm-MIBI imaging in patients with hyperparathyroidism.

OBJECTIVETo study the effects of Compound Danshen Dripping Pill (CDDP) on the structure and functions of sternohyoid muscle in metabolic syndrome (MS) rats, and to study whether it has therapeutic effects on obstructive sleep apnea-hypopnea syndrome (OSAHS).

METHODSTwenty-one healthy male SD rats were randomly divided into three groups, i.e., the normal control group (n = 6), the MS group (n = 8), and the CDDP group (n = 7). Rats in the normal control group were routinely fed. High lipid forage was given to rats in the rest two groups. Nine weeks later, CDDP (at the dose of 375 mg/kg) was additionally given to rats in the CDDP group by gastrogavage, and then rats in the CDDP group and the MS group were fed with the same high lipid forage for 12 successive weeks. The content of malondialdehyde (MDA) and the activities of superoxide dismutase (SOD) in the sternohyoid muscle were detected in the three groups. The capillary density, capillary-to-fiber ratio (C/F), the section area of type I muscle fiber were detected using myosin-ATPase histochemical assay. The contractile changes of isometric stemohyoid muscles were determined under electric stimulation by different frequencies.

RESULTSThe contents of MDA were obviously lower in the CDDP group than in the MS group, while the activities of SOD, the capillary density, C/F, the section area of type I muscle fiber, the tension of stemohyoid muscle at 10 -60 Hz, and the 1-5 min tension percentages of the stemohyoid muscle were higher in the CDDP group than in the MS group (P < 0.05, P < 0.01).

CONCLUSIONCDDP could improve oxidative stress induced intramuscularly microcirculation disturbance and changes of muscular fiber structures of the upper airway muscles, and elevate their contractile functions, thus possibly contributing to favorable effects on OSAHS.

Animals ; Capillaries ; Drugs, Chinese Herbal ; pharmacology ; Male ; Metabolic Syndrome ; metabolism ; Muscle Contraction ; drug effects ; Neck Muscles ; drug effects ; metabolism ; Oxidative Stress ; drug effects ; Phenanthrolines ; pharmacology ; Rats ; Rats, Sprague-Dawley

OBJECTIVETo observe the effect of pure total flavonoids from Citrus (PTFC) on the hepatic fatty degeneration, inflammation, oxidative stress and SIRT1/PGC-1alpha expressions in mice with non-alcohol steatohepatitis (NASH), and discuss the action mechanism of PTFC on NASH.

METHODMice were given high-fat diet for 16 weeks to induce the NASH model. Since the seventh week after the model establishment, the mice were intervened with 100, 50 and 25 mg x kg(-1) x d(-1) PTFC for 10 weeks. The pathologic changes in hepatic tissues were observed with HE staining. The contents of TG, CHOL in hepatic tissue, as well as the levels of AST, ALT in serum were detected by using the biochemical process. The expression of SIRT1, PGC-1alpha and MnSOD mRNA in hepatic tissues were detected with Real-time PCR assay. SIRT1, PGC-1alpha protein and 8-OHdG expressions were determined with the immunohistochemical method. The SOD level in hepatic tissues was tested by the xanthine oxidase method. The MDA content in hepatic tissues was examined by the thiobarbituric acid method.

RESULTThe contents of TG, CHOL, NAFLD activity scores and ALT level in serum in hepatic tissues of mice in the model induced by fat-rich diet were obviously higher than that of the normal group (P < 0.010. The SIRT1, PGC-1alpha, MnSOD mRNA and protein expression in hepatic tissues were significantly lower than that of the normal group (P < 0.01). The expression of 8-OHdG and the content of MDA in hepatic tissues were obviously higher than that of the normal group (P < 0.01). After the intervention with different doses of PTFC, the NAFLD activity scores, the content of TG and the level of AST in serum were notably lower than that of the normal group (P < 0.01, P < 0.05); whereas the SIRT1, PGC-1alpha, MnSOD mRNA and protein expression were obviously higher than that of the normal group (P < 0.01, P < 0.05), with the significant decrease in the expression of 8-OHdG and the content of MDA (P < 0.01).

CONCLUSIONOxidative stress/lipid peroxidation enhancement in in NASH mice induced by high-fat diet may be related to the changes in SIRT1/PGC-1alpha signal transduction pathway. PTFC could enhance the anti-oxidant capacity in liver, relieve the damage of reactive oxygen during the fatty acid metabolic process, and prevent NASH from the occurrence and development by regulating the SIRT1/PGC-1alpha signal pathway.

Animals ; Citrus ; chemistry ; Fatty Liver ; drug therapy ; genetics ; metabolism ; Flavonoids ; chemistry ; pharmacology ; Inflammation ; drug therapy ; genetics ; metabolism ; Liver ; drug effects ; metabolism ; Male ; Mice ; Mice, Inbred C57BL ; Non-alcoholic Fatty Liver Disease ; Oxidative Stress ; drug effects ; genetics ; Peroxisome Proliferator-Activated Receptor Gamma Coactivator 1-alpha ; Sirtuin 1 ; genetics ; metabolism ; Transcription Factors ; genetics ; metabolism

This study aimed to investigate the involved immunologic mechanism of pure total flavonoids from Citrus (PTFC) on the development of non-alcoholic steatohepatitis (NASH). C57BL/6 mice were fed with high .fat diet for 16 weeks to induce the NASH model, and from the 7th week three dosages (25, 50 and 100 mg x kg(-1) x d(-1)) of PTFC were administrated intragastric for 10 weeks respectively. Serum TG, CHOL, ALT, AST were determined by biochemical assay, histopathological changes of the liver tissue were observed by HE staining, expression of RORyt and Foxp3 mRNA of the liver tissue was detected by Real-time PCR, and serum IL-17, IL-6, IL-10 and IL-4 were determined by.Cytometric Beads Array. As a result, we find that after the administration of PTFC, the in- flammation of the liver tissue of NASH mice was attenuated, liver function was improved, and the expression of RORgammat mRNA was higher in the liver tissue while which was lower of Foxp3 mRNA, the level of proinflammatory cytokines IL-17 and IL-6 decreased and the level of suppressive cytokines IL-10 and IL-4 increased. These data show that PTFC protects the development of NASH through regulating the Th17/Treg balance and attenuating inflammation.
Animals ; Citrus ; chemistry ; Cytokines ; blood ; Flavonoids ; pharmacology ; Male ; Mice ; Mice, Inbred C57BL ; Non-alcoholic Fatty Liver Disease ; immunology ; prevention & control ; T-Lymphocytes, Regulatory ; drug effects ; Th17 Cells ; drug effects

Objective To analyze the effects of rehabilitation training,acupuncture and the combination of these two therapies on the motor function of stroke survivors,and to evaluate their health economics.Methods Two hundred and five stroke survivors were randomly divided into a rehabilitation group (64 cases),an acupuncture group (69 cases) and a combined group (72 cases).The rehabilitation group received conventional rehabilitation training for 28 days,while the acupuncture group received scalp needling combined with body acupuncture.The combined group received both the training and the acupuncture.The clinical neural functional deficiency scale (NDS) and functional comprehensive assessments (FCA) were evaluated at baseline and on the 28th day after treatment and 28th day after the treatment had ended.The total cost including the direct medical costs,direct non-medical costs and indirect costs were calculated and analyzed.Results The NDS and FCA scores showed no significant difference between the three groups at baseline.At the 28th day after treatment and and 28th day after the treatment had ended,both the NDS and FCA scores had improved significantly in all groups compared with the baseline.However,there was no significant difference between the groups.At the 28th day there was a significant difference in the NDS results of the combined group compared to the other two groups.Significant differences in NDS results among all three groups had appeared by the 56th day,but there was still no significant difference in average FCA scores.At the 28th day no significant difference in cost was observed among the three groups,but the combined group spent significantly less in total cost,direct medical costs,direct non-medical costs and indirect costs for a one point NDS decrement.However,there was no significant difference in the cost of producing a one point increment in FCA among the three groups.Conclusion Combining rehabilitation training with acupuncture is more economical and effective than either treatment alone.

Objective To analyse the necessity of colposcopic directed biopsy to vaginal intraepithelial neoplasia (VAIN) before hysterectomy due to early stage cervical cancer (stage Ⅰ) or high grade cervical intraepithelial neoplasia (CIN). Methods A total of 669 patients who underwent a hysterectomy due to early stage cervical cancer (stage Ⅰ) and CINⅢin Beijing Obstetrics and Gynecology Hospital, Capital Medical University,from January 1, 2009 to December 31, 2013 and followed up, 99 patients with VAIN were enrolled. The clinical data and following up the prognosis were prospectively analyzed retrospectively. Results The occurrence rate of VAIN before and after hysterectomy due to cervical dysplasia was 14.8%(99/669), the occurrence rate and the grade of VAIN showed that significantly increased from CINⅢto cervical cancer stageⅠ(P<0.05);Only 15 patients enrolled had undergone vaginal wall biopsy by colposcopy pre-hysterectomy, including 11 patients who were diagnosed with VAINⅡ-Ⅲand underwent vagina extended resection during the hysterectomy. The 5 year recurrence rate of vaginal stump VAIN after hysterectomy was 12.1%(12/99) and the progression rate was 4.0%(4/99), the recurrent rate was 2.0%(2/99). Conclusions For all the patients who are planning to undergo hysterectomy due to stageⅠcervical cancer and CINⅢ, routine upper side of the vagina wall colposcopic-directed biopsy pre-hysterectomy is strongly recommended. All the patients after hysterectomy due to cervical dysplasia should be followed up regularly within 3 years after hysterectomy.

Objective To evaluate the effectiveness of standardized three-stage rehabilitation program on spasticity and motor function in the upper extremities after cerebral hemorrhage.Methods A total of 364 patients were included and randomly assigned to a control group (n =181) and a rehabilitation group (n =183).The standardized three-stage rehabilitation program,which included early-stage bedside rehabilitation,specialized treatment in rehabilitation ward during recovery and rehabilitation follow-up at regular intervals was applied in the rehabilitation group,but only rehabilitation guidance and follow-up after discharge were provided for the control group.The modified Ashworth scale (MAS) and Fugl-Meyer assessment (FMA) were performed at the time of recruitment,1 month (M1),3 months(M3) and 6 months(M6) later.Results There was no statistical difference between the groups at recruitment.The occurrence rate of spasticity was 22.7％ in the control and 23.5％ in the rehabilitation group.At M6 the occurrence rate of spasticity was about 59.7％ and 43.2％ in control group and rehabilitation group respectively,and the number of patients grade 1 + and grade 2 on the MAS was 50/181 in the control group,significantly more than in the rehabilitation group (25/183).At all time points,MAS grade 0 accounted for a large proportion of both groups.At M6,both MAS distributions and scores of the two groups were different statistically (P ＜ 0.01).FMA scores in both groups increased significantly (P ＜ 0.01) with time,with the score being (17.13 ± 16.46),(24.87±18.36),(30.68±19.41) at M1,M3 and M6 in the control group and (24.71 ±19.80),(39.83 ± 19.50),(48.87 ± 18.25) in the rehabilitation group,but the average scores of the latter were consistently significantly higher than the former (P ＜ 0.01).Conclusions Standardized three-stage rehabilitation can alleviate spasticity and improve motor function of the upper extremities in cerebral hemorrhage patients.

Objective To study the effect of hyperbaric oxygen(HBO) treatment on plasma endotoxin,sCD14 and plasma endotoxin inactivation capacity(EIC) in acute necrotizing pancreatitis(ANP) in rats and its possible mechanism.Methods SD rats were randomly divided into control group,sham operation group,ANP group and ANP+HBO group.Rat ANP models were made by retrograde injection of 3.5% sodium(taurocholate)(2.5mL/kg) into the pancreatic duct.Thirty minues after models had been made,ANP+HBO group was treated by hyperbaric oxygen for 2h.At 3h,6h,and 10h after establishment of rat models,the plasma endotoxin,sCD14,EIC,TXB_2 and 6-K-PGF_(1a) leves were determined in each group.Results At 3h and 6 h after rat models were established,the levels of endotoxin,sCD14,and TXB_2 in ANP+HBO group were significantly lower than those in ANP group(P

Objective: To investigate the serum uric acid levels among residents living in Balikun County, Xinjiang Uygur Autonomous Region from 2018 to 2021, so as to provide insights into local hyperuricemia control. Methods: The residents at ages of 20 to 69 years undergoing physical examinations in Balikun County Hospital during the period from 2018 to 2021 were enrolled. Their age, gender, and history of medication and disease were collected, and serum uric acid levels were measured. The gender- and age-specific prevalence of hyperuricemia and hypouricemia was descriptively analyzed. Results: A total of 3 097 subjects were enrolled, which included 1 210 males ( 39.07% ) and 1 887 females ( 60.93% ) and had a mean age of ( 46.12±12.84 ) years. The overall mean serum uric acid was ( 260.41±71.99 ) μmol/L, and the mean serum uric acid was ( 298.22±69.57 ) μmol/L in men and ( 236.17±62.44 ) μmol/L in women. The serum uric acid level appeared a tendency towards a rise with ages both in whole study subjects and in women ( P<0.05 ). The overall prevalence of hyperuricemia was 4.26%, with 4.63% prevalence in men and 4.03% in women. The prevalence of hyperuricemia appeared a tendency towards a rise with ages both in whole study subjects and in women ( P<0.05 ). The overall prevalence of hypouricemia was 0.71%, with 0.25% prevalence in men and 1.01% in women; the prevalence of moderate hypouricemia was 11.11%, with 2.56% prevalence in men and 16.59% in women. Conclusions Low level of serum uric acid and prevalence of hyperuricemia is detected among residents living in Balikun County. Monitoring of serum uric acid is recommended to be intensified among men.